| NPI | 1881963163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC HESTRUP Member 630-788-7990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038011756) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070019008) |
| Enumeration Date | 2011-12-15 |
| Last Update Date | 2013-05-22 |